Healthcare Provider Details

I. General information

NPI: 1063251254
Provider Name (Legal Business Name): BETH ANNE SIGMAN CNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2024
Last Update Date: 05/20/2024
Certification Date: 05/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 RIVERSIDE PARK RD APT 10
BISMARCK ND
58504-5389
US

IV. Provider business mailing address

121 RIVERSIDE PARK RD APT 10
BISMARCK ND
58504-5389
US

V. Phone/Fax

Practice location:
  • Phone: 701-214-9185
  • Fax:
Mailing address:
  • Phone: 701-214-9185
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number98724
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: